Healthcare Environmental Resource Center (HERC)

Texas

Special/Medical Waste

Definition of Regulated Medical Waste
Managing Regulated Medical Waste
OSHA Regulations
Statutes, Regulations and Guidelines
Contacts
More Information

Definition of Regulated Medical Waste

The term "special waste from health-care-related facilities" (SWFHCRF) is used to define regulated waste, including:

Animal waste from animals intentionally exposed to pathogens;
Bulk human blood and blood products;
Pathological waste;
Microbiological waste; and
Sharps.

A chain of events is necessary to produce disease from contact with medical waste:

The waste must contain a viable (capable of living/reproducing) human pathogen (disease producing organism);
A portal of entry must exist for an organism to enter the body;
There must be a sufficient number of organisms entering this portal of entry to produce an infection; and
There must be a susceptible host, and if infection does occur, disease may or may not occur.

Sharps, due to their inherent ability to provide a portal of entry, must be managed properly regardless of their contamination status.

The OSHA Bloodborne Pathogen Standard also defines regulated medical waste. This definition applies to waste within a facility. It is more comprehensive that the state’s SWFHCRF definition. This is because "universal precautions" must be observed in facilities where actual physical contact with potentially infectious materials can be expected to occur on a regular basis.

*Texas regulations are based on the idea that waste properly packaged and labeled at the point of generation reduces the amount of waste that needs to be handled by special means. Compliance with OSHA and Texas regulations can be achieved by simply re-evaluating what waste goes where at the point of generation.

*OSHA only requires a waste container marked with the BIOHAZARD symbol and word, although "red bags" may be substituted. If these bags are used to collect medical waste that is not SWFHCRF, their identity should be changed so

waste handlers will not be alarmed. Designation of the BIOHAZARD container should be documented in the Exposure Control Plan. The specified receptacle may then be lined with a regular trash bag, which may be disposed of as routine municipal solid waste if it does not contain any items of SWFHCRF.

Managing Regulated Medical Waste

Texas has designed comprehensive regulations that track medical waste from generation to disposal.

Treatment and Disposal of Treated Medical Waste

The following treatment and disposition methods for special waste from health care-related facilities are approved by the Texas Board of Health (board) for the waste specified. Where a special waste from a health care-related facility is also subject to the sections in Chapter 289 of this title (relating to Radiation Control), the sections in Chapter 289 shall prevail over the sections in this undesignated head. Disposal of special waste from health care-related facilities in sanitary landfills or otherwise is under the jurisdiction of the Texas Natural Resource Conservation Commission and is governed by its rules found in Title 30, Texas Administrative Code, Chapter 330.

1. Animal waste. Animal waste shall be subjected to one of the following methods of treatment and disposal.

(I) Carcasses of animals intentionally exposed to pathogens shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. carcasses of animals intentionally exposed to pathogens which are not contagious may be buried on site under the supervision of a veterinarian licensed to practice veterinary medicine in the State of Texas;

iv. carcasses of animals intentionally exposed to pathogens which are not contagious may be sent to a rendering plant;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

(II) Body parts of animals intentionally exposed to pathogens shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. steam disinfection followed by grinding and discharging into a sanitary sewer system;

iii. incineration followed by deposition of the residue in a sanitary landfill;

iv. body parts of animals intentionally exposed to pathogens which are not contagious may be buried on site under the supervision of a veterinarian licensed to practice veterinary medicine in the State of Texas;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

(III) Bulk whole blood, serum, plasma, and/or other blood components from animals intentionally exposed to pathogens shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. steam disinfection followed by grinding and discharging into a sanitary sewer system;

iii. incineration followed by deposition of the residue in a sanitary landfill;

iv. thermal inactivation followed by deposition in a sanitary landfill;

v. thermal inactivation followed by grinding and discharging into a sanitary sewer system;

vi. chemical disinfection followed by deposition in a sanitary landfill;

vii. chemical disinfection followed by grinding and discharging into a sanitary sewer system;

viii. bulk blood, serum, plasma, and/or other blood components of animals intentionally exposed to pathogens which are not contagious may be buried on site under the supervision of a veterinarian licensed to practice veterinary medicine in the State of Texas;

ix. moist heat disinfection followed by deposition in a sanitary landfill;

x. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

xi. an approved alternate treatment process followed by deposition in a sanitary landfill.

(IV) Bedding of animals intentionally exposed to pathogens shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. bedding of animals intentionally exposed to pathogens which are not contagious may be buried on site under the supervision of a veterinarian licensed to practice veterinary medicine in the State of Texas;

iv. moist heat disinfection followed by deposition in a sanitary landfill;

v. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vi. an approved alternate treatment process followed by deposition in a sanitary landfill.

2. Bulk human blood, bulk human blood products, and bulk human body fluids. Bulk human blood, blood products, and body fluids shall be subjected to one of the following methods of treatment and disposal:

(I) discharging into a sanitary sewer system;

(II) steam disinfection followed by deposition in a sanitary landfill;

(III) incineration followed by deposition of the residue in a sanitary landfill;

(IV) chemical disinfection followed by deposition in a sanitary landfill;

(V) chemical disinfection followed by grinding and flushing into a sanitary sewer system;

(VI) thermal inactivation, followed by deposition in a sanitary landfill;

(VII) thermal inactivation, followed by grinding and discharging into a sanitary sewer system;

(VIII) moist heat disinfection followed by deposition in a sanitary landfill;

(IX) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(X) an approved alternate treatment process followed by deposition in a sanitary landfill.

3. Microbiological waste. Microbiological waste shall be subjected to one of the following methods of treatment and disposal.

(I) Discarded cultures and stocks of infectious agents and associated biologicals shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. thermal inactivation followed by deposition in a sanitary landfill;

iv. chemical disinfection followed by deposition in a sanitary landfill;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

(II) Discarded cultures of specimens from medical, pathological, pharmaceutical, research, clinical, commercial, industrial and veterinary laboratories shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. thermal inactivation followed by deposition in a sanitary landfill;

iv. chemical disinfection followed by deposition in a sanitary landfill;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

(III) Discarded live and attenuated vaccines, but excluding the empty containers thereof, shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. thermal inactivation followed by deposition in a sanitary landfill;

iv. chemical disinfection followed by deposition in a sanitary landfill;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

(IV) Discarded disposable culture dishes shall be subjected to one of the following methods of treatment and disposal.

i. All discarded, unused disposable culture dishes shall be disposed of in accordance with Title 30, Texas Administrative Code, Chapter 330.

ii. Discarded, used disposable culture dishes shall be subjected to the following methods of treatment and disposal:

4. steam disinfection followed by deposition in a sanitary landfill;

5. (II) incineration followed by deposition of the residue in a sanitary landfill;

6. (III) thermal inactivation followed by deposition in a sanitary landfill;

7. (IV) chemical disinfection followed by deposition in a sanitary landfill;

8. (V) moist heat disinfection followed by deposition in a sanitary landfill;

9. (VI) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

10. (VII) an approved alternate treatment process followed by deposition in a sanitary landfill.

(I) Discarded disposable devices used to transfer, inoculate or mix cultures shall be subjected to one of the following methods of treatment and disposal:

i. steam disinfection followed by deposition in a sanitary landfill;

ii. incineration followed by deposition of the residue in a sanitary landfill;

iii. thermal inactivation followed by deposition in a sanitary landfill;

iv. chemical disinfection followed by deposition in a sanitary landfill;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process followed by deposition in a sanitary landfill.

11. Pathological waste. Pathological waste shall be subjected to one of the following methods of treatment and disposal.

(I) Human materials removed during surgery, labor and delivery, autopsy, embalming, or biopsy shall be subjected to one of the following methods of treatment and disposal:

i. body parts:

(II) interment;

(III) incineration followed by deposition of the residue in a sanitary landfill;

(IV) steam disinfection followed by interment;

(V) moist heat disinfection, provided that the grinding/shredding renders the item as unrecognizable, followed by deposition in a sanitary landfill;

(VI) chlorine disinfection/maceration, provided that the grinding/shredding renders the item as unrecognizable, followed by deposition in a sanitary landfill; or

(VII) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill;

i. tissues or fetuses:

12. incineration followed by deposition of the residue in a sanitary landfill;

13. (II) grinding and discharging to a sanitary sewer system;

14. (III) interment;

15. (IV) steam disinfection followed by interment;

16. (V) moist heat disinfection followed by deposition in a sanitary landfill;

17. (VI) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

18. (VII) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill;

i. organs:

(II) incineration followed by deposition of the residue in a sanitary landfill;

(III) grinding and discharging to a sanitary sewer system;

(IV) interment;

(V) steam disinfection followed by interment;

(VI) moist heat disinfection followed by deposition in a sanitary landfill;

(VII) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(VIII) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill;

i. bulk human blood and bulk human body fluids removed during surgery, labor and delivery, autopsy, embalming, or biopsy:

19. discharging into a sanitary sewer system;

20. (II) steam disinfection followed by deposition in a sanitary landfill;

21. (III) incineration followed by deposition of the residue in a sanitary landfill;

22. (IV) thermal inactivation followed by deposition in a sanitary landfill;

23. (V) thermal inactivation followed by grinding and discharging into a sanitary sewer system;

24. (VI) chemical disinfection followed by deposition in a sanitary landfill;

25. (VII) chemical disinfection followed by grinding and discharging into a sanitary sewer system;

26. (VIII) moist heat disinfection followed by deposition in a sanitary landfill;

27. (IX) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or (X) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill.

(I) The products of spontaneous or induced human abortion shall be subjected to one of the following methods of treatment and disposal:

i. body parts, tissues, or organs regardless of the period of gestation:

(II) grinding and discharging to a sanitary sewer system;

(III) incineration followed by deposition of the residue in a sanitary landfill;

(IV) steam disinfection followed by interment;

(V) interment;

(VI) moist heat disinfection followed by deposition in a sanitary landfill;

(VII) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(VIII) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill;

i. blood and body fluids:

28. discharging into a sanitary sewer system;

29. (II) steam disinfection followed by deposition in a sanitary landfill;

30. (III) incineration followed by deposition of the residue in a sanitary landfill;

31. (IV) thermal inactivation followed by deposition in a sanitary landfill;

32. (V) thermal inactivation followed by grinding and discharging into a sanitary sewer system;

33. (VI) chemical disinfection followed by deposition in a sanitary landfill;

34. (VII) chemical disinfection followed by grinding and discharging into a sanitary sewer system;

35. (VIII) moist heat disinfection followed by deposition in a sanitary landfill;

36. (IX) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

37. (X) an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill.

(I) Discarded laboratory specimens of blood and/or tissues shall be subjected to one of the following methods of treatment and disposal:

i. grinding and discharging into a sanitary sewer system;

ii. steam disinfection followed by deposition in a sanitary landfill;

iii. steam disinfection followed by grinding and discharging into a sanitary sewer system;

iv. incineration followed by deposition of the residue in a sanitary landfill;

v. moist heat disinfection followed by deposition in a sanitary landfill;

vi. chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

vii. an approved alternate treatment process, provided that the process renders the item as unrecognizable, followed by deposition in a sanitary landfill.

(II) Anatomical remains shall be subjected to one of the following methods of treatment and disposal:

i. interment;

ii. incineration followed by interment; or

iii. steam disinfection followed by interment.

38. Sharps.

(I) All discarded unused sharps shall be disposed of in accordance with Title 30, Texas Administrative Code, Chapter 330.

(II) Contaminated sharps shall be subjected to one of the following methods of treatment and disposal.

i. Hypodermic needles, and hypodermic syringes with attached needles, shall be subjected to one of the following methods of treatment and disposal:

(III) chemical disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(IV) steam disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

(V) incineration, and if the item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

(VI) encapsulation in a matrix which will solidify and significantly reduce the possibility of puncture wounds followed by deposition in a sanitary landfill;

(VII) moist heat disinfection followed by deposition in a sanitary landfill;

(VIII) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(IX) an approved alternate treatment process, provided that the process renders the item as unrecognizable and can no longer cause puncture wounds, followed by deposition in a sanitary landfill.

i. Razor blades, disposable razors, and disposable scissors used in surgery, labor and delivery, or other medical procedures; and scalpel blades shall be subjected to one of the following methods of treatment and disposal:

39. chemical disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

40. (II) steam disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

41. (III) incineration, and if item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

42. (IV) encapsulation in a matrix which will solidify and significantly reduce the possibility of puncture wounds followed by deposition in a sanitary landfill;

43. (V) moist heat disinfection followed by deposition in a sanitary landfill;

44. (VI) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

45. (VII) an approved alternate treatment process, provided that the process renders the item as unrecognizable and can no longer cause puncture wounds, followed by deposition in a sanitary landfill.

i. Intravenous stylets and rigid introducers (e.g., J wires) shall be subjected to one of the following methods of treatment and disposal:

(II) chemical disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(III) steam disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(IV) incineration, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(V) encapsulation in a matrix which will solidify and significantly reduce the possibility of puncture wounds, followed by deposition in a sanitary landfill;

(VI) moist heat disinfection followed by deposition in a sanitary landfill;

(VII) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(VIII) an approved alternate treatment process, provided that the process renders the item as unrecognizable and can no longer cause puncture wounds, followed by deposition in a sanitary landfill.

i. Glass pasteur pipettes, glass pipettes, specimen tubes, blood culture bottles, and microscope slides, and broken glass from laboratories shall be subjected to one of the following methods of treatment and disposal:

46. chemical disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

47. (II) steam disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

48. (III) incineration, and if the item can cause puncture wounds, placement in a puncture-resistant container followed by deposition in a sanitary landfill;

49. (IV) encapsulation in a matrix which will solidify and significantly reduce the possibility of puncture wounds followed by deposition in a sanitary landfill;

50. (V) moist heat disinfection followed by deposition in a sanitary landfill;

51. (VI) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

52. (VII) an approved alternate treatment process, provided that the process renders the item as unrecognizable and can no longer cause puncture wounds, followed by deposition in a sanitary landfill.

i. Tattoo needles, acupuncture needles, and electrolysis needles shall be subjected to one of the following methods of treatment and disposal:

(II) chemical disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(III) steam disinfection, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(IV) incineration, and if the item can cause puncture wounds, placement in a puncture-resistant, leak-proof container followed by deposition in a sanitary landfill;

(V) encapsulation in a matrix which will solidify and significantly reduce the possibility of puncture wounds, followed by deposition in a sanitary landfill;

(VI) moist heat disinfection followed by deposition in a sanitary landfill;

(VII) chlorine disinfection/maceration followed by deposition in a sanitary landfill; or

(VIII) an approved alternate treatment process, provided that the process renders the item as unrecognizable and can no longer cause puncture wounds, followed by deposition in a sanitary landfill.

Specific categories of SWFHCRF may be treated by specific methods. Chlorine disinfection/maceration and moist heat disinfection require shredding of the waste during or shortly after treatment.

Other parameters including such things as time, temperature and pressure requirements are specified for other methods.

The U.S. Environmental Protection Agency (EPA) requires registration of chemical disinfectants (except for household bleach or 70 percent isopropyl alcohol). EPA also requires that liquid disinfectants be drained from treated wastes.

Approval from the Office of Air Quality of the Texas Natural Resource Conservation Commission (TNRCC) is required for incineration processes.

Any generator that produces more than 50 pounds per calendar month of SWFHCRF and that treats all or part of the wastes on-site is required to perform routine performance monitoring based on the volume of SWFHCRF generated monthly and the type of treatment process utilized.

On-Site vs. Off-Site Treatment

"On-site" means a facility consisting of contiguous structures or contiguous properties, or a combination of structures operated by a single entity operating under a license issued by the Texas Department of Health.

A frequently encountered situation involves the waste disposal activities of a hospital that owns a separate building containing physicians’ offices. Facilities that meet certain criteria may be able to handle such waste as their own "on-site generated" waste. If the hospital accepts and processes waste that was generated off-site, then that hospital then takes on the role of a commercial processor and must be permitted as a commercial facility.

On-Site Treatment

Records must be kept for waste treated on-site to include the date, amount of waste, method of treatment, name and initials of the person performing treatment, and for generators of more than 50 pounds per month, a written procedure for the operation and testing of any equipment or chemicals used. Records must be maintained for three years and must be available for review on request.

Treated wastes may be disposed of as routine municipal solid waste provided any markings identifying the waste as SWFHCRF are covered with a color-coded disposable container or a label identifying the waste as "treated." Recognizable human body parts, tissues, fetuses, organs, and the products of spontaneous or induced abortions must not be disposed of in a municipal solid waste landfill.

Sharps must be placed in containers designed for their disposal. Treated or unused sharps, if not encapsulated, must be segregated from the regular solid waste stream and transported without compaction to the landfill. If the contents of a sharps container are completely encased in an encapsulating matrix and can withstand an applied pressure of 40 pounds per square inch, the sharps container may be disposed of with routine municipal solid waste. Treated and/or encapsulated sharps containers must be labeled as such.

Off-Site Treatment

Wastes to be transported off-site for treatment must be packaged securely in a bag of specified strength requirements and subsequently boxed in a rigid outer container also meeting specified strength requirements. The outer container must be labeled twice in English and twice in Spanish with the words "CAUTION, contains medical waste that may be biohazardous."

Sharps must be placed in marked and puncture-resistant containers designed for their disposal.

Ultimately, the generator's primary responsibility whenever allowing untreated SWFHCRF to be transported off-site is to determine that the waste is being released to a currently registered transporter and to obtain a signed receipt for each shipment of regulated waste.

Transport of Medical Waste

Transporters of untreated medical waste must comply with applicable vehicle, financial assurance, registration, reporting, and fee requirements.

Certain exemptions exist for generators who choose to transport their own untreated medical waste:

Generators of less than 50 pounds per month may transport their own waste to a registered medical waste collection station, transfer station, storage facility, or processing facility without meeting transporter requirements.
Generators of more than 50 pounds per month may still transport their own waste provided they meet all transporter requirements except registration.
Generators located contiguous to a permitted processing facility may transport their own untreated waste without complying with packaging requirements provided the waste is identified as "untreated" and is not transported over a public roadway.

Transfer of shipments of untreated medical waste must take place only at and on the premises of a permitted transfer station, storage facility, or processing facility. In case of vehicle malfunction or accident, the waste may be transferred to another vehicle, and the TNRCC must be notified within five days in the case of vehicle malfunction or one day in the case of an accident. Interstate transportation requires the same conditions as for transporters operating within Texas, except that only the vehicle requirements apply to transporters of waste that neither originates nor terminates in Texas.

A licensed hospital may act as a medical waste collection station, may be registered in counties of less than one million population, and may accept waste only from generators of less than 50 pounds per month that transport their own untreated waste.

Storage

All medical waste must be stored in a secure manner and location that affords protection from theft, vandalism, inadvertent human or animal exposure, rain, water, and wind. It must be managed so it will not provide a breeding place or food for insects or rodents and will not generate noxious odors.

A permit is required for the storage of medical waste generated off-site except on the premises of a permitted processing facility or medical waste collection station. Such waste must be maintained at a temperature of 45 degrees Fahrenheit or less if held for more than 72 hours.

For registered transporters whose base of operations is located more than 200 miles from a permitted processing facility, untreated medical waste may be held up to one week without refrigeration. Medical waste generated off-site and held for more than 14 days is considered to be in storage, and authorization from TNRCC’s executive director is required.

OSHA Regulations HERC OSHA State Page

In addition to the state medical waste environmental regulations there are some Occupational Safety and Health Administration (OSHA) rules that apply to medical/infectious waste. Texas is one of 26 states covered entirely by the federal OSHA program. This program is operated by the Occupational Safety and Health Administration. OSHA rules (Occupational Exposure to Bloodborne Pathogens Standards) impact various aspects of medical/infectious waste, including management of sharps, requirements for containers that hold or store medical/infectious waste, labeling of medical/infectious waste bags/containers, and employee training. These requirements can be found in the HERC section entitled OSHA Standards for Regulated Waste.